Key Insights On Integrating EHR Into Your Practice

Bruce Werber, DPM, FACFAS

The challenges of integrating a new practice management system and electronic health records (EHR) system into your practice can be tremendous, especially with a busy practice. However, these upgrades can increase efficiency and potentially reduce the need for additional staff members, thereby improving your bottom line.

   In addition, an integrated practice management system can reduce the potential for errors and the need to enter the same data multiple times. If one must enter the data multiple times, the rate of errors increases exponentially. The secret to rapid payment is submitting clean claims with excellent documentation. One can achieve this by reducing the number of times staff needs to enter patient demographic information and insurance information into the system.

   Additionally, having a software package that verifies the patient’s coverage, deductibles and co-pays improves your ability to collect the appropriate payment at the time of service. The system should scrub each claim to ensure that one places the appropriate CPT codes and ICD-9 codes as well as modifiers appropriately within the electronic claim.

   Once the claim is paid, it will be remitted electronically and posted electronically in your system. This also reduces staff time in processing payments and reduces errors.

   Additionally, data collection can be automated in the latest systems with scanners having the capability of scanning driver’s licenses and insurance cards, and inputting data directly into the demographics section of the software package. Again, this is another step in automation to reduce the risk of incorrect data collection.

Essential Pearls For Implementing The New System

Preparation is essential. First, the physicians cannot delegate this task to their staff or the office manager as physicians must fully participate in the evaluation of practice management systems and electronic health record systems/electronic medical record (EMR) systems.

   After choosing a system that fits the practice model and method, then the real preparation begins. The practice must collect and document all of the insurance/worker’s compensation companies that they do business with on a regular basis. The staff should include the provider numbers of these companies, electronic payor ID numbers, addresses and phone numbers.

   One must decide on an electronic claims clearinghouse (intermediary). Typically, the software package has already developed this intermediary relationship and the package will assist in the process of signing up with the payor intermediary. Be aware that it can take upward of six to eight weeks to have authorization from Medicare and the larger insurance companies to start utilizing electronic submission or even changing how you submit your claims electronically.

   The practice needs to identify all of the CPT codes that it uses as well as the charge schedules for each CPT code and supplies that the practice uses and/or sells. One must gather reimbursement fee schedules from the insurance carriers. This will be necessary in order for the system to identify when the practice receives a payment correctly or incorrectly, and report any incorrect payments to your staff.

   The practice must develop a list of referring physicians with names, phone numbers, fax numbers and addresses to input into the system. This will simplify the process of sending out consultation and thank you letters after treating a patient.

   It is time to evaluate your scheduling process. Developing templates for scheduling will improve your practice efficiency by maximizing your time. Consider how much time is necessary to see each type of patient and then establish an appropriate template for each day. Consider blocking certain types of patients to one specific time section. For example, see all post-op patients on Tuesday mornings and all orthotic follow-ups on Tuesday afternoons. This helps your staff be prepared and moves the patient flow along much more effectively.

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